Appendicitis Irrigation Technique with ZERO Abscesses!

A prior study from Kansas City showed no difference in outcomes between irrigation and no irrigation in perforated appendicitis

The study 'Standardized Irrigation Technique Reduces Intra-abdominal Abscess After Appendectomy' by Leplant and Salsman was published in August 2018 Journal of Pediatric Surgery

The University of Minnesota surgeon's technique uses peritoneal irrigation for serial dilution with multiple low aliquots and debridement of fibrous material

For perforation, the technique uses up to 6 liters of normal saline

For extensive peritonitis with or without interloop abscess, the technique uses 9 to 12 liters of normal saline

Zero patients developed intra-abdominal abscess out of 140 patients after irrigation for serial dilution

18 out of 292 patients developed intra-abdominal abscess after discretionary irrigation

The technique has drawbacks including tediousness and time added to the operation

The surgeon uses 50 cc aliquots with a total of 6 liters, which equals 120 irrigation cycles

The group that did not use the intensive irrigation technique had approximately 6% post-operative abscess rate